Purpose: To evaluate the clinical characteristics, management strategies, and surgical outcomes of tractional and/or rhegmatogenous retinal detachment (TRD/RRD) in eyes with retinoblastoma (RB). Methods: A retrospective surgical case series of patients with treated RB at a tertiary referral center (June 2014–April 2025) who developed non-exudative retinal detachment (RD) was conducted. The data included demographics, tumor activity, RB treatment modalities received, RD features, surgical approach, complications, anatomical reattachment, and final visual acuity. Results: Seven eyes of seven patients (0.9%) developed TRD or RRD. Four eyes had RRD, two had combined RRD/TRD, and one had TRD. Early RRD during active RB was treated with nondrainage scleral buckling ( n = 2), whereas late detachments after complete tumor regression underwent pars plana vitrectomy with silicone oil tamponade ( n = 4). Anatomical reattachment at one year was achieved in 83.3% of the operated eyes (five of six eyes undergoing surgery), with no cases of tumor seeding or reactivation observed. One eye was enucleated due to tumor progression. Visual acuity improved to baseline or better in 71.4% of the eyes. Conclusions: In this small series, early RRD during active RB was managed with nonsurgical scleral buckling without evidence of tumor dissemination, and late complex RRD after confirmed tumor quiescence was treated with pars plana vitrectomy and silicone oil tamponade with favorable anatomical outcomes. No tumor seeding or reactivation was observed in any case. However, these findings should be interpreted with caution, given the small sample size, and do not allow definitive conclusions regarding oncologic safety.

Background/Objectives: To assess the knowledge, attitudes, and practices of ophthalmologists in Saudi Arabia towards genomic medicine and genetic testing, in light of the growing significance of genomics in ophthalmology and the national transition towards precision medicine. Methods: A cross-sectional, questionnaire-based survey was conducted among ophthalmologists, including consultants, specialists, fellows, and residents, across Saudi Arabia. The questionnaire included four domains: demographics, knowledge of genomic principles and gene therapy, self-rated confidence in genetic tasks (scored 1–10), and attitudes toward genetic testing. Data were analyzed using descriptive and inferential statistics, with subgroup comparisons performed using chi-square tests and t-tests/ANOVA. Results: A total of 115 ophthalmologists participated (46% male, 54% female; mean age 34 years; mean post-board experience 4 years). Most were consultants (40%) and practiced in Riyadh (52%). Knowledge was variable: 92% correctly identified human chromosome count, and 99% recognized autosomal recessive inheritance, but only 9% answered DNA base-pairing correctly, and 54% recognized mitochondrial inheritance. Confidence was highest for referral to specialists (mean 7.3/10) and lowest for test selection and counseling (4.7/10). The internet was the primary knowledge source among our sample (65%). The majority of individuals had positive attitudes towards genomic medicine: 90% believed testing was beneficial, 89% considered it enhanced health outcomes, and 89% indicated they would undergo testing themselves. On the other hand, 77% indicated difficulty in access, 91% strongly concurred on the significance of privacy and confidentiality, and more than half expressed concerns regarding misuse and bias. Conclusions: Ophthalmologists in Saudi Arabia acknowledge the importance of genetics. Yet, there are substantial gaps in knowledge and familiarity with genomic medicine and genetic testing. To overcome these challenges, it is essential to integrate genetics into ophthalmology curricula.